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Contact Information

JUDITH T JACKSON, PSYCHOLOGIST
125 COULTER AVE
FLOOR 2
ARDMORE, PA19003-2410
 Phone: 610-642-4873
 Fax: 610-642-4886
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JUDITH T JACKSON · (Female)

NPI Number 1497973911
Status Active
Credentials PSYCHOLOGIST
Entity Individual
Enumeration date 04/22/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • PA License # PS007219L
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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